Heme/Onc KPs2

Question 1

pembrolizumab MoA? Approved for?

Answer 1

PD-1 inhibitor.

treatment of mismatch-repair deficient tumors (tumors with high microsatellite instability), regardless of the tissue of origin.

Question 2

Who are candidates for brest cancer prophylaxis?

What are the prophylaxis options?

Answer 2

> 35, 5year risk of 1.7% with lobular carcinoma in situ or atypical ductal hyperplasia

tamoxifen prior to menopause and with tamoxifen, raloxifene, or exemestane after menopause

Question 3

Women with BRCA1/2 mutations should undergo breast cancer screening when?

Answer 3

MRI beginning at age 25 years and mammography beginning at age 30 years

Question 4

In patients with estrogen receptor–positive DCIS, this decreases the risk of local recurrence of both DCIS and invasive cancer? Caveat?

Answer 4

adjuvant tamoxifen

no survival benefit

Question 5

in postmenopausal women younger than 60 years with DCIS, treat with?

Answer 5

anastrozole > tamoxifen

Question 6

Mastectomy is recommended for?

Answer 6

extra-breast involvement, 2+ breast quadrants, inflammatory breast cancer

Question 7

How to stage inflammatory breast cancer? Treatment?

Answer 7

CT and bone scan

chemotherapy, followed by surgery, and then radiation

Question 8

Therapy-related hot flushes in breast cancer survivors may be improved with?

Answer 8

SSRIs, SNRIs

Question 9

All women with ovarian cancer are eligible for?

Answer 9

BRCA1/2 testing

Question 10

How to stage ovarian cancer?

Answer 10

surgical exploration

Question 11

Follow-up for treated ovarain cancer? This has no role

Answer 11

CA-125 monitoring;

no role for continued imaging

Question 12

Test NOT helping for colon cancer staging?

Answer 12

PET

Question 13

Treatment of stage III colon cancer?

Answer 13

adjuvant 5-FU + surgery

Question 14

All patients with metastatic colorectal cancer should undergo tumor genotyping to identify mutations in?

Why?

Answer 14

K-ras and N-ras.

anti–epidermal growth factor receptor antibodies, cetuximab and panitumumab, are inactive in the 50% of tumors that harbor mutations.

Question 15

Anal cancer is often curable with?

Answer 15

radiation therapy and concurrent chemotherapy with mitomycin plus 5-fluorouracil

Question 16

Anal cancer - natural course after treatment? Implication?

Answer 16

continue to regress for 6 months to 1 year following completion of radiation therapy

treatment failure should not be declared unless unequivocal growth or metastases are documented

Question 17

Treatment of metastatic gastroesophageal cancer?

Answer 17

Palliative with cisplant+trastuzaumab if HER-2

Question 18

General treatment of neuroendocrine tumors?

Answer 18

because so indoluent. can effectively be managed with expectant observation and serial imaging

Question 19

Patients with metastatic gastrointestinal stromal tumors are treated with lifelong?

Answer 19

Imatinib

Question 20

Class of lung cancer characterized by various paraneoplastic syndromes?

Answer 20

NSCLC

Question 21

Limited-stage small cell lung cancer is defined as?

Answer 21

confined to a single hemithorax (could include supraclavicalar lymph nodes)

Question 22

Extensive-stage small cell lung cancer is treated with?

Answer 22

Platinum-containing doublet

Question 23

How do Human papillomavirus tumors from squamous cell carcinoma of the head and neck?

Answer 23

exclusively within the oropharynx, develop in younger individuals, and are associated with a significantly improved prognosis.

Question 24

Active surveillance, with the use of serum prostate-specific antigen measurement, digital rectal examination, and repeat prostate biopsy, is appropriate only for men with?

Answer 24

very low–risk or low-risk prostate cancer who have a life expectancy of at least 10 years

Question 25

Active prostate cancer after surgery is defined as? After radiation?

Answer 25

Any identifiable level of prostate specific antigen a progressive increase in the serum PSA level

Question 26

In patients with prostate cancer, these reduce the incidence of skeletal-related events?

Answer 26

zoledronic acid and denosumab

Question 27

Patients with a biochemical recurrence of prostate cancer (a rising serum prostate-specific antigen level and no evidence of local disease progression) are treated with?

Answer 27

androgen deprivation therapy

Question 28

dentification of new-onset hematuria in patients older than 40 years mandates ?

Answer 28

Cystoscopy

Question 29

WHen can lymph nodes be followed with serial exams alone (no imaging/labs)?

Answer 29

small, soft, freely moveable lymph nodes that are limited to one or two adjacent sites

Question 30

Do not use this test to diagnose lymphoma?

Answer 30

FNA

Question 31

only curative therapy for follicular lymphoma?

Answer 31

allo-HCT

Question 32

Treatment of MALT lymphoma not responsive to H pylori abx?

Answer 32

surgical removal, involved-field radiation therapy + rituximab

Question 33

Diagnosis of chronic lymphocytic leukemia is confirmed by? prognosis is determined by ?

Answer 33

flow cytometry indicating co-expression of cell surface antigens CD5 and CD23 gene mutation status (immune globulin variable heavy-chain mutation) and fluorescence in situ hybridization or array-based karyotyping.

Question 34

When can CLL be observed without therapy?

Answer 34

if asymptomatic and stage 0 to II

Question 35

Drug for CLL?

Answer 35

Ibrutinib

Question 36

Hairy cell leukemia presents wtih?

Answer 36

splenomegaly without lymphadenopathy

Question 37

Early-stage cutaneous T-cell non-Hodgkin lymphoma is treated with? If advanced?

Answer 37

topical glucocorticoids, retinoids, and psoralen and ultraviolet light with interferon alfa. chemotherapy, purine analogs, histone deacetylase inhibitors, and monoclonal antibodies.

Question 38

Patients with cancer of unknown primary site and isolated cervical lymphadenopathy should undergo?

Answer 38

triple endoscopic examination (upper endoscopy, bronchoscopy, and laryngoscopy)

Question 39

Women with adenocarcinoma limited to lymph nodes in one or both axillae have what type of cancer until proven otherwise? Get this test?

Answer 39

breast - breast MRI

Question 40

oung men with poorly differentiated carcinoma that is relatively symmetrical around the midline - likely is?

Answer 40

Germ cell tumor

Question 41

Drug for metastatic melanoma? For patients with metastatic melanoma and a V600 BRAF mutation?

Answer 41

ipilimumab Targeted therapy (BRAF inhibitor like Vemurafenib)

Question 42

In patients with pleural effusion - max fluid to drain?

Answer 42

1500 cc

Question 43

Spontaneous tumor lysis syndrome occurs commonly in patients with?

Answer 43

Leukemia and Burkitt lymphoma

Question 44

everyone on Aromatase ibhibitors should also be on?

Answer 44

calcium and vitamin D supplements to avoid osteopenia fractures

Question 45

women treated early in life with mantle radiation therapy are likley to develop what other cancers?

Answer 45

Breast cancer (radiation induced)